Why Does My Heel Hurt? A Podiatrist's Guide to Heel Pain

Heel pain is one of the most common reasons people book in to see us at The Foot Clinic Group. Whether it's a dull ache that builds up over the day or a sharp stab with your first steps in the morning, heel pain can make everyday activities — walking the dog, standing at work, going for a run — surprisingly difficult. The good news is that most heel pain is very treatable once we understand what's causing it.

What Causes Heel Pain?

There are several common culprits behind heel pain, and pinpointing the right one matters because the treatment for each is different.

Plantar fasciitis is by far the most common cause. The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel to your toes. When it becomes irritated or overloaded, it causes pain typically felt at the bottom of the heel, often worst with the first few steps in the morning or after sitting for a while.

Heel spurs are small calcium deposits that can form on the heel bone, often alongside plantar fasciitis. Contrary to popular belief, the spur itself is rarely the source of pain — it's usually the surrounding soft tissue irritation that causes discomfort.

Achilles tendinopathy causes pain at the back of the heel, where the Achilles tendon attaches to the heel bone. This is common in people who've recently increased their walking or running load, or who wear unsupportive footwear.

Fat pad irritation or atrophy can cause deep, bruise-like heel pain, particularly in older adults or those who spend long hours on hard flooring.

Stress fractures, nerve entrapment, and referred pain from the lower back or ankle are less common but important causes that a podiatrist will rule out during an assessment.

When Should You See a Podiatrist?

You don't need to wait until the pain is unbearable. It's worth booking an appointment if:

• Heel pain has lasted more than a week or two

• Pain is worse with your first steps in the morning

• The pain is affecting how you walk or your daily activities

• You've tried rest and stretching without improvement

• You have diabetes or a condition affecting circulation or nerve sensation, in which case any persistent foot pain should be checked promptly

Early assessment generally means a faster, simpler recovery. Left untreated, heel pain can lead to compensatory issues in the knees, hips, or lower back as you unconsciously change the way you walk.

How We Diagnose and Treat Heel Pain

At your first appointment, your podiatrist will take a detailed history, assess your foot structure and gait, and examine the painful area. This might include:

• A biomechanical and gait assessment to identify contributing factors like foot posture, muscle tightness, or footwear

• Manual palpation to pinpoint the exact source of pain

• Referral for imaging (ultrasound or X-ray) if a stress fracture or spur needs to be confirmed

Treatment is tailored to the underlying cause, but commonly includes:

• Stretching and strengthening programs for the calf muscles and plantar fascia

• Footwear advice to ensure your shoes are providing adequate support

• Custom or off-the-shelf orthotics to correct biomechanical issues placing excess strain on the heel

• Taping or strapping to offload the area while it heals

• Dry needling or soft tissue therapy to reduce muscle and fascial tightness

• Activity modification to reduce load while healing occurs

Most people see meaningful improvement within a few weeks of starting the right treatment plan, though full resolution of plantar fasciitis can take longer for cases that have been present for months.

Simple Things You Can Try at Home

While you wait for your appointment, a few gentle measures can help:

• Roll your foot over a cold water bottle or ball for a few minutes at a time

• Stretch your calf and the sole of your foot, especially before getting out of bed

• Choose supportive, cushioned footwear and avoid walking barefoot on hard surfaces

• Reduce high-impact activity temporarily until you've been assessed

These won't replace a proper diagnosis, but they can take the edge off in the meantime.

Book an Assessment

Heel pain rarely goes away on its own if the underlying cause isn't addressed — and the earlier it's treated, the easier it usually is to resolve. Our podiatrists see heel pain regularly across all three of our clinics and can put together a treatment plan suited to your foot type, activity level, and lifestyle.

• Aspendale Gardens (Aspendale Gardens Medical Centre) — Book online

• Rowville (Wellness on Wellington) — Book online

• Scoresby (Rise Health Group) — Book online